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• W2977853640 abstract "Purpose: We describe a case of telaprevir-induced pancreatitis and the subsequent outcome of completed course of therapy for hepatitis C. Case: A 55-year-old female with Genotype 1 hepatitis C infection had been a partial responder to prior therapy with ribavirin and peginterferon alfa 2a. This course of therapy was discontinued after 11 weeks when she developed symptomatic hyperthyroidism. Three years later, treatment was reinitiated with ribavirin, peginterferon alfa 2a and telaprevir. In her 7th week of therapy, she presented with acute pancreatitis requiring hospitalization. Her labs on admission showed amylase of 5,946 u/L, lipase > 2,000 u/L and normal LFTs. Abdominal CT revealed fluid adjacent to the pancreatic head, consistent with acute pancreatitis. Ultrasound at the time and subsequently showed “possible small gallbladder stones versus sludge.” MR cholangiography was negative for filling defects or ductal dilation. Serum triglycerides and IgG4 level were normal. She denied alcohol use and had no family or personal history of pancreatitis. Other medications on admission were not known to cause pancreatitis. She was managed conservatively and improved. Her triple therapy regimen was continued during the five days of hospitalization. Amylase, lipase, AST, ALT were 127, 90, 48 and 32 u/L respectively on discharge. In close follow-up five days later, she remained asymptomatic, although her amylase and lipase had risen to 173 and 333 u/L. In the following week, she developed severe abdominal pain and was readmitted. Admission labs: amylase 3,714, lipase > 2,000, AST 85, ALT 51 u/L. All of her hepatitis C medications were held. She quickly improved with conservative management and was discharged 4 days later. LFTs continued to trend down and lipase had normalized on the day of discharge. She had received nine weeks of telaprevir. Six days after discharge, she was clinically stable, and ribavirin and peginterferon alfa 2a were restarted at her prior dose. She had no further episodes of recurrent pancreatitis. Her amylase and lipase were normal on repeat labs, and she completed 48 weeks of therapy. At three and six months post completion of therapy, HCV RNA level was undetectable. Discussion: To date, there has been only one other report of telaprevir-induced pancreatitis. Our case is the first to describe the natural course of this idiosyncratic reaction and its effect on HCV therapy. Although there have been reports of ribavirin and peginterferon causing acute pancreatitis, in this patient with telaprevir-induced pancreatitis, ribavirin and peginterferon alpha 2a were continued without any further complication of recurrent pancreatitis." @default.
• W2977853640 created "2019-10-10" @default.
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• W2977853640 date "2013-10-01" @default.
• W2977853640 modified "2023-09-28" @default.
• W2977853640 title "Telaprevir-induced Pancreatitis Complicating Hepatitis C Treatment" @default.
• W2977853640 doi "https://doi.org/10.14309/00000434-201310001-01096" @default.
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